How to relieve headache caused by hydrocephalus?

Written by Tang Li Li
Neurology
Updated on September 13, 2024
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Hydrocephalus causing headaches is generally related to high pressure in the brain. Hydrocephalus leads to an enlargement of the ventricular system, compressing the surrounding brain tissue. Since the volume of the skull is fixed, increased accumulation of fluid can cause a rapid rise in internal pressure, leading to headaches. In severe cases, it may cause nausea, vomiting, and disturbances in consciousness, making the patient drowsy, stuporous, or even comatose. In such cases, the main treatment is to reduce the pressure inside the brain. Dehydrating agents, such as mannitol, can be used; however, mannitol mainly removes water from inside the cells and is more effective for cerebral edema than for hydrocephalus. Furosemide can be used to reduce the secretion of cerebrospinal fluid and may have some effect on hydrocephalus. However, the key treatment is likely to be surgical, such as lateral ventricular drainage, which can fundamentally resolve the problem of fluid accumulation but can also lead to complications like infections.

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Written by Chen Yu Fei
Neurosurgery
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Is hydrocephalus serious?

Hydrocephalus is relatively serious. When hydrocephalus occurs, it gradually affects the patient's motor functions of the limbs, causing weakness in one or both sides, difficulty in lifting, walking impairments, difficulty performing fine motor actions, and ataxia. It may even lead to frequent falls. Additionally, there are significant cognitive impairments, characterized by reduced intelligence levels, decreased computational abilities, and even certain degrees of language dysfunctions. Patients may also exhibit significant personality changes, such as feelings of anxiety, depression, apathetic expressions, and a dislike for communication and interaction with others.

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Written by Chen Yu Fei
Neurosurgery
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Is hydrocephalus easy to treat?

Hydrocephalus is relatively easy to treat. Before treatment, it is advised to first perform a cranial CT scan or MRI on the patient to determine the type and severity of the hydrocephalus, and based on whether the patient currently shows significant clinical symptoms, decide if surgical treatment is necessary. Additionally, a cranial CT or MRI can help identify the cause of the hydrocephalus, such as whether there is an intracranial space-occupying lesion or if the cerebral fluid circulation pathway is obstructed for other reasons, leading to hydrocephalus. If treatment is deemed necessary, it is generally recommended to opt for ventriculo-peritoneal shunt surgery for the patient. Most patients can achieve good results after the surgical treatment.

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Written by Chen Yu Fei
Neurosurgery
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Does hydrocephalus affect intelligence?

Mild hydrocephalus generally does not significantly affect intellectual levels, while moderate or severe hydrocephalus often impacts a patient’s intelligence. In children, it can cause severe impairment in intellectual development. For adults, it results in noticeable intellectual deficiencies, primarily characterized by significant cognitive dysfunction, reduced memory, diminished calculating abilities, and weakened verbal communication skills. Additionally, individuals may appear indifferent, speak less, are reluctant to interact with others, and have difficulty expressing themselves. Furthermore, most patients experience reduced orientation abilities concerning time, people, and space, which are predominantly caused by hydrocephalus.

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Written by Chen Yu Fei
Neurosurgery
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Is hydrocephalus easy to treat?

For patients with hydrocephalus, it is generally recommended to treat the condition surgically. Before the surgery, the patient should undergo a cranial CT or MRI to assess the type and severity of the hydrocephalus. If possible, a lumbar puncture should also be performed before the surgery to determine whether there is a significant increase in intracranial pressure, and a small amount of cerebrospinal fluid should be collected for routine and biochemical analysis of the cerebrospinal fluid. If there are no obvious contraindications to surgery, clinically, it is generally recommended to choose a ventriculoperitoneal shunt surgery. Most patients respond well to the surgery, and the morphology of the ventricular system gradually returns to normal.

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Written by Chen Yu Fei
Neurosurgery
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How to alleviate pain from hydrocephalus?

For patients with hydrocephalus, if there is significant pain, it is mostly caused by increased intracranial pressure, often seen in progressive hydrocephalus, or obstructive hydrocephalus. As the cerebrospinal fluid gradually increases and accumulates, it leads to the expansion of the ventricular system and causes extensive hydrocephalus, accompanied by gradually increasing intracranial pressure. To alleviate the pain, one might consider taking oral long-acting analgesics to help relieve the pain. Additionally, the use of mannitol or performing a lumbar puncture to release a small amount of cerebrospinal fluid may be considered to ease the pain. However, the key is to achieve the ultimate resolution of the disease through surgery.